- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,342.40 / $16,563.30 / $21,769.90
| Facility | | $11,342.40 | $16,563.30 | $21,769.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,727.09 / $12,978.45 / $21,774.02
| Facility | | $4,727.09 | $12,978.45 | $21,774.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,938.42 / $16,713.58 / $29,812.31
| Facility | | $11,938.42 | $16,713.58 | $29,812.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,267.22 / $18,567.00 / $27,109.35
| Facility | | $14,267.22 | $18,567.00 | $27,109.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,267.22 / $17,260.50 / $27,109.35
| Facility | | $14,267.22 | $17,260.50 | $27,109.35 |